The Japanese American Community Diabetes Study (JACDS) began in 1983 to describe the metabolic effects of westernization that may contribute to the higher risk for type 2 diabetes observed in Japanese Americans compared with native Japanese and US non-Hispanic whites. This prospective study enrolled a total of 735 men and women of 100% Japanese ancestry. Study visits occurred at baseline, 2.5 years, 5-6 years and 10- 11 years. Complete data for key variables is available for 733 subjects for 1 visit, and 70% of subjects have complete data for 3 visits. At each visit information about medical history, medication use, family history, diet, and physical activity was obtained, and weight, height, blood pressure, fasting blood tests (insulin, glucose and lipids), and visceral (intra-abdominal) fat area by computed tomography were measured. A 75-g oral glucose tolerance test was also performed at each visit. The overall aim of the proposed research is to use this rich longitudinal database to improve knowledge about the clinical significance of excess visceral fat (visceral adiposity). Our specific aim is to determine the associations between visceral adiposity, cardiovascular disease (CVD) mortality and all-cause mortality after accounting for differences in age, sex, smoking, body mass index, diet and physical activity. Mortality and cause of death from death certificates will be ascertained through December 31, 2005 by searching the National Death Index. We project that during the average follow-up period of 18 years there will be 111 deaths from CVD and 250 deaths from all causes among the 733 subjects with complete data for 1 visit. The results of this study will lead to a clearer understanding of the clinical impact of visceral adiposity on cardiovascular disease mortality and all-cause mortality after accounting for commonly used measures of obesity, such as body mass index. PUBLIC HEALTH RELEVANCE: This project is relevant to the public health because it will determine whether excess body fat inside the abdomen (visceral fat) contributes to the risk of death. We will also see whether the risk of death is higher in people who have more visceral fat even after accounting for obesity based on height and weight, diet and physical activity. This study also will improve understanding of the health risks for Asian Americans.